1979, 09-13 Permit: 79-3902 Addition PLAN NU, 3f..r{2 �� APPLICATION/PERMIT / ' PERMIT NUMBER I
�//•- SPOKANE COUNTY - BUILDING CODES DEPARTMENT '"'//� 7493 �
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES C
JOB ADDRESS 0 * * 3J'0 0
1. "/0 HO, 6N LEGAL DESCRIPTION - SEE ATTACHED * 35.0 0 N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 1454_2.. _1;6;7,5
2Ce---2VV �I10Ca, 5f L�
* 3 5 0 0 U
OWNER IPHONE * ao0
3. his C � � 5W -3977
ADDR SS Z Required Set Backs in Feet V 3 9 0 1 2
1 G �U �� 1 �� North 7 1V2- (South I [East 'H .�- (West 3� 0 9- 1 3-7 9
CONTRACTOR PHONE Size of Parcel Zone Classificat. n ' I
4. 80S.-/A/ S5 92/4 / 67 " I f s -tk i 2-16 ..LilJ j . 2 6,4 7 9,
ADDRESS ZIP Type Const. Occupancy Spr nklered
Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation 1BuiIdingrea nn Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area r Gar, ,g Area Storage —
PYa
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
,�,/ No. Baths No. Floors No. Rooms Rec. Room
TYPE L1! NEW CI ALT. AD'N. ❑ RPL. ❑ MVE.
7. OF ✓ ElOTHER
WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
•
DESCRIBE WORK
8 t�j�_X46 ( ��� ) FEES COLLECTED
VALUATION�j Source ! GAS ELECT".6C WATER SEWER
9. COV of t//
Utilities Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 6, v° —
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. Plumbing
b
DATE CV�-,-_, 4 ' ' 9,//02)/ 7 SIGNATURE C<f_/I.LtJ Cf-K57%
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. f'j, � i\--r-W1-1w
- y� Plan Check
Env.Health I f✓r�l"l� IW' vim"
l SEPA o
Planning U
- LU
Mobile Home
Fire Marshall z
Co.Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
} WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist r / THISBECOMESA PERMIT.
9 —.1 3''— ? 9
. . ,/
, ,:.( * 35, fn
DATE OFFICIAL- �� . U L d
APPROVED FOR ISSUANCE
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PROPOSED 1
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t/OrnApiciLe IiEl6MT$ ..+h Add1 7
VCILUMG 3 PLFrr 8 Al 6c-- _9
SPOKANE CCu,iTY, wHCA,
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